Single-center experience in kidney transplantation: outcomes, conclusions, and perspectives

Kidney transplantation (KT) remains the best treatment for patients with chronic kidney disease (CKD) stage 4–5. It helps patients live longer, have better quality of life, and undergo improved medical and social rehabilitation. This paper examines the outcomes of KT performed between 2019 and 2023....

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Main Authors: M. Sh. Khubutia, I. V. Dmitriev, A. G. Balkarov, Yu. A. Anisimov, N. V. Shmarina, N. V. Zagorodnikova, N. V. Borovkova, M. G. Minina, D. V. Lonshakov, V. O. Aleksandrova, V. Smirnova, A. U. Rustambek
Format: Article
Language:Russian
Published: Federal Research Center of Transplantology and Artificial Organs named after V.I.Shumakov 2025-01-01
Series:Вестник трансплантологии и искусственных органов
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Online Access:https://journal.transpl.ru/vtio/article/view/1875
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author M. Sh. Khubutia
I. V. Dmitriev
A. G. Balkarov
Yu. A. Anisimov
N. V. Shmarina
N. V. Zagorodnikova
N. V. Borovkova
M. G. Minina
D. V. Lonshakov
V. O. Aleksandrova
V. Smirnova
A. U. Rustambek
author_facet M. Sh. Khubutia
I. V. Dmitriev
A. G. Balkarov
Yu. A. Anisimov
N. V. Shmarina
N. V. Zagorodnikova
N. V. Borovkova
M. G. Minina
D. V. Lonshakov
V. O. Aleksandrova
V. Smirnova
A. U. Rustambek
author_sort M. Sh. Khubutia
collection DOAJ
description Kidney transplantation (KT) remains the best treatment for patients with chronic kidney disease (CKD) stage 4–5. It helps patients live longer, have better quality of life, and undergo improved medical and social rehabilitation. This paper examines the outcomes of KT performed between 2019 and 2023.Materials and methods. There were 1,106 KTs deceased donor KTs performed between January 1, 2029, and December 31, 2023. The recipients had a median age of 45 (37–54) years, with 664 (60%) males and 442 (40%) females. Donors were mainly males (n = 706, 63.8%), with the median donor age being 50 (43–57) years. Induction immunosuppressive therapy (IST) with monoclonal antibodies was administered to 859 (77.7%) recipients, with polyclonal antibodies to 122 recipients (11%), and induction without antibodies to 125 recipients (11.3%). Triple-drug baseline IST consisted of a combination of calcineurin inhibitors, antimetabolites and glucocorticoids. Tacrolimus was the most often utilized calcineurin inhibitor (n = 961, 86.9%), while cyclosporine was used less often (n = 145, 13.1%). Mycophenolic acid (n = 1041, 94.1%) was used as the second medication in most recipients, while everolimus (n = 54, 4.9%) and azathioprine (n = 11, 1%) were used less often.Results. Primary initial renal graft function was noted in 714 patients (64.6%) and delayed in 392 recipients (35.4%). Overall incidence of surgical complications was 11.6% (n = 130), and immunological complications 9.9% (n = 109). At hospital discharge, 768 recipients (69.4%) had satisfactory kidney allograft (KAG) function, while 276 recipients (25%) were discharged with graft dysfunction; median serum creatinine and blood urea levels were 158 (120–204) μmol/L and 11 (8–16) mmol/L, respectively. Twenty-six recipients (2.4%) were discharged to continue renal replacement therapy; 28 recipients (2.6%) underwent in-hospital graft nephrectomy. Twelve individuals passed away during the hospitalization phase. The cumulative uncensored in-hospital graft and recipient survival rates were 97.5% (n = 1078) and 98.9% (n = 1094), respectively.Conclusion. KT is an effective and safe transplant modality for stage 4–5 CKD. Our KT outcomes are consistent with those of reputable transplant centers around the globe.
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publishDate 2025-01-01
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spelling doaj-art-ca558a2e39cb4f0eab2a8138d92c7c6b2025-08-20T03:01:39ZrusFederal Research Center of Transplantology and Artificial Organs named after V.I.ShumakovВестник трансплантологии и искусственных органов1995-11912025-01-01264909910.15825/1995-1191-2024-4-90-991314Single-center experience in kidney transplantation: outcomes, conclusions, and perspectivesM. Sh. Khubutia0I. V. Dmitriev1A. G. Balkarov2Yu. A. Anisimov3N. V. Shmarina4N. V. Zagorodnikova5N. V. Borovkova6M. G. Minina7D. V. Lonshakov8V. O. Aleksandrova9V. Smirnova10A. U. Rustambek11Sklifosovsky Research Institute for Emergency Medicine; Moscow State University of Medicine and Dentistry; Research Institute for Healthcare Organization and Medical ManagementSklifosovsky Research Institute for Emergency Medicine; Pirogov Russian National Research Medical UniversitySklifosovsky Research Institute for Emergency Medicine; Research Institute for Healthcare Organization and Medical Management; Pirogov Russian National Research Medical UniversitySklifosovsky Research Institute for Emergency Medicine; Moscow State University of Medicine and DentistrySklifosovsky Research Institute for Emergency Medicine; Pirogov Russian National Research Medical UniversitySklifosovsky Research Institute for Emergency MedicineSklifosovsky Research Institute for Emergency Medicine; Pirogov Russian National Research Medical UniversityBotkin HospitalSklifosovsky Research Institute for Emergency MedicineSklifosovsky Research Institute for Emergency MedicineSklifosovsky Research Institute for Emergency MedicineSklifosovsky Research Institute for Emergency MedicineKidney transplantation (KT) remains the best treatment for patients with chronic kidney disease (CKD) stage 4–5. It helps patients live longer, have better quality of life, and undergo improved medical and social rehabilitation. This paper examines the outcomes of KT performed between 2019 and 2023.Materials and methods. There were 1,106 KTs deceased donor KTs performed between January 1, 2029, and December 31, 2023. The recipients had a median age of 45 (37–54) years, with 664 (60%) males and 442 (40%) females. Donors were mainly males (n = 706, 63.8%), with the median donor age being 50 (43–57) years. Induction immunosuppressive therapy (IST) with monoclonal antibodies was administered to 859 (77.7%) recipients, with polyclonal antibodies to 122 recipients (11%), and induction without antibodies to 125 recipients (11.3%). Triple-drug baseline IST consisted of a combination of calcineurin inhibitors, antimetabolites and glucocorticoids. Tacrolimus was the most often utilized calcineurin inhibitor (n = 961, 86.9%), while cyclosporine was used less often (n = 145, 13.1%). Mycophenolic acid (n = 1041, 94.1%) was used as the second medication in most recipients, while everolimus (n = 54, 4.9%) and azathioprine (n = 11, 1%) were used less often.Results. Primary initial renal graft function was noted in 714 patients (64.6%) and delayed in 392 recipients (35.4%). Overall incidence of surgical complications was 11.6% (n = 130), and immunological complications 9.9% (n = 109). At hospital discharge, 768 recipients (69.4%) had satisfactory kidney allograft (KAG) function, while 276 recipients (25%) were discharged with graft dysfunction; median serum creatinine and blood urea levels were 158 (120–204) μmol/L and 11 (8–16) mmol/L, respectively. Twenty-six recipients (2.4%) were discharged to continue renal replacement therapy; 28 recipients (2.6%) underwent in-hospital graft nephrectomy. Twelve individuals passed away during the hospitalization phase. The cumulative uncensored in-hospital graft and recipient survival rates were 97.5% (n = 1078) and 98.9% (n = 1094), respectively.Conclusion. KT is an effective and safe transplant modality for stage 4–5 CKD. Our KT outcomes are consistent with those of reputable transplant centers around the globe.https://journal.transpl.ru/vtio/article/view/1875kidney transplantationpost-kidney transplant complicationsimmunological complicationsacute kidney transplant rejectionkidney transplant survivalrecipient survival
spellingShingle M. Sh. Khubutia
I. V. Dmitriev
A. G. Balkarov
Yu. A. Anisimov
N. V. Shmarina
N. V. Zagorodnikova
N. V. Borovkova
M. G. Minina
D. V. Lonshakov
V. O. Aleksandrova
V. Smirnova
A. U. Rustambek
Single-center experience in kidney transplantation: outcomes, conclusions, and perspectives
Вестник трансплантологии и искусственных органов
kidney transplantation
post-kidney transplant complications
immunological complications
acute kidney transplant rejection
kidney transplant survival
recipient survival
title Single-center experience in kidney transplantation: outcomes, conclusions, and perspectives
title_full Single-center experience in kidney transplantation: outcomes, conclusions, and perspectives
title_fullStr Single-center experience in kidney transplantation: outcomes, conclusions, and perspectives
title_full_unstemmed Single-center experience in kidney transplantation: outcomes, conclusions, and perspectives
title_short Single-center experience in kidney transplantation: outcomes, conclusions, and perspectives
title_sort single center experience in kidney transplantation outcomes conclusions and perspectives
topic kidney transplantation
post-kidney transplant complications
immunological complications
acute kidney transplant rejection
kidney transplant survival
recipient survival
url https://journal.transpl.ru/vtio/article/view/1875
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